The impact of apathy on cognitive performance in the elderly

Abstract

Objectives To examine the impact of apathy on cognitive performance in the elderly following the conceptual principles proposed by Marin 1 and Stuss et al 2 and to determine the role of the symptoms of apathy in different cognitive domains. Methods Cross‐sectional study with a cohort of healthy elderly subjects over 55 years old (n = 140). One hundred forty healthy‐elderly subjects (aged 79.24 ± 8.6 years old) were recruited from 12 day centers in Northern Spain. Participants underwent a neuropsychological battery, which evaluated Mini Mental State Examination (MMSE), attention, processing speed, verbal fluency, visual and verbal memory, working memory, and executive functioning. Apathy was assessed by the Lille Apathy Rating Scale (LARS), which is composed of four factors: intellectual curiosity, emotion, action initiation, and self‐awareness. Correlation and linear regression analyses were performed. Results In the correlational analysis, the LARS total score correlated negatively with global cognition, verbal fluency, and visual and verbal memory. The intellectual curiosity factor correlated negatively with all cognitive domains except attention. The emotion factor correlated negatively with visual memory. No correlation was found between the action initiation and self‐awareness factors or any of the cognitive variables. Multiple stepwise regression analysis showed that symptoms of apathy explained cognitive performance in attention, processing speed, verbal fluency, visual and verbal memory, working memory, executive functioning, and MMSE. Conclusions Apathy was significantly associated with cognitive performance, especially with the intellectual curiosity factor. Our results suggest that specific symptoms of apathy contribute differently to individual cognitive domains.

Antidopaminergic treatment is associated with reduced chorea and irritability but impaired cognition in Huntington’s disease (Enroll-HD)

“…Psychiatric measures were included as they can affect cognitive abilities, likely due to a variety of factors including anhedonia, decreased motivation, concentration difficulties and impairments in attention and processing speed. 19 In addition to using propensity score matching, we verified our results using covariate adjustment, based on the findings by Elze et al, 20 which showed that this more conventional technique may be the most reliable method for the analysis of observational databases. To do this, we compared the yearly rate of change between the group taking antidopaminergic medication (n=2369) and the group of non-takers (n=2642) using a univariate analysis of variance (ANOVA) with the following covariate variables: age, gender, CAG repeat length, DBS, TFC and time since diagnosis (see online supplementary section).…”

Apathy and agitation in institutionalized older adults: an empirically derived classification

“…3,12,13 Apathy is a complex syndrome characterized by a persistent lack of motivation not attributable to altered levels of consciousness that may affect selfgenerated behaviours, cognitive performance, and emotional-affective processing. 14,15 It has been shown to be the most common syndrome in degenerative dementia and is strongly associated with higher cognitive impairments. [15][16][17][18] Apathy is related to executive impairment and the capacity of the frontal cortex to select, initiate, maintain, and shift actions.…”

“…14,15 It has been shown to be the most common syndrome in degenerative dementia and is strongly associated with higher cognitive impairments. [15][16][17][18] Apathy is related to executive impairment and the capacity of the frontal cortex to select, initiate, maintain, and shift actions. 19,20 Less attention is paid to apathy than other BPSD, possibly because in an institutional context it is less intrusive, despite being directly linked with high levels of disability in PWD.…”

Apathy and executive functioning among non‐demented community‐dwelling elderly individuals in an everyday environment: the mediating effect of impulsivity

“…cognitive apathy dimension) 16,17 . In fact, a higher level of apathetic symptoms rated on behavioural scales is robustly associated with poorer executive functioning in non‐demented older adults, especially in spontaneous flexibility, inhibition, and working memory, 9,10,18 which is in line with the hypothesis that executive impairment is one of several psychological components involved in manifestations of apathy 6 . Executive impairment appears to be both a consequence and a crucial factor in the onset of apathy, but little is known about its specific association with apathy subdomains.…”